Hepatocellular carcinoma (HCC) is one of the most common
malignancies worldwide with an annual occurrence of one million new cases. The incidence of liver
metastasis is much higher than the incidence of HCC. Overall nearly 50% of the patients with colorectal
adenocarcinoma will develop liver
metastasis. Surgical resection remains the "gold standard" for resectable
hepatic neoplasms, but only a minority of patients present with lesions which are potentially curable. In these nonresectable hepatic
tumors palliative treatment using focal
necrosis by
hyperthermia (radiofrequency, microwave coagulation
therapy, interstitial
laser photocoagulation, thermo-ablation with hot water
steam) appear as a valuable alternative. Best results are reported in the case of associations of thermo-
necrosis with general or intraarterial
chemotherapy. These methods of treatment can be performed by percutaneous, laparoscopic or open approach. Precise guidance of the focal
necrosis can be realized using CT scan, IRM and intraoperative ultrasound exam and the results are evaluated by the same techniques. The key
element in the management of the malignant
tumors of the liver is the cooperation between surgeon,
intensive care physician, oncologist and specialist in interventional radiology, to appreciate the indication of
therapy. Further controlled trials are required to define the precise indications and long term results of these methods of treatment.